The effect of telephone social support and education on adaptation to breast cancer during the year following diagnosis.

PURPOSE/OBJECTIVES: To find the most effective methods of providing social support for women diagnosed with breast cancer by testing the effectiveness of a telephone social support and education intervention to promote emotional and interpersonal adaptation to breast cancer. DESIGN: Multisite, two-group experimental study with repeated measures. SETTING: Arkansas and New Jersey. SAMPLE: The Arkansas sample consisted of 106 women who entered the study two to four weeks postsurgery for nonmetastatic breast cancer and were randomly assigned to an experimental or control group. The comparison group consisted of 91 women from New Jersey who had participated in a previously completed study that used the same interventions and found that telephone support resulted in more positive, statistically significant adaptation to the disease. METHODS: The experimental group received 13 months of telephone social support and education. Both groups received educational materials via a mailed resource kit. The Profile of Mood States; Visual Analogue Scale-Worry; Relationship Change Scale; University of California, Los Angeles, Loneliness Scale-Version 3; and the modified Symptom Distress Scale provided data regarding the variables of interest. Data analysis included descriptive statistics, t tests, and multivariate analysis of variance with repeated measures. MAIN RESEARCH VARIABLES: Mood, worry, relationships with significant others, loneliness, and symptoms. FINDINGS: Data analysis showed no significant differences between groups, and both improved on some of the outcomes. Significant time-by-location interaction effects were found when comparing the Arkansas and New Jersey samples, thereby supporting the need to consider regional differences when developing interventions. CONCLUSIONS: The mailed educational resource kit alone appeared to be as effective as the telephone social support provided by oncology nurses in conjunction with the mailed resource kit. IMPLICATIONS FOR NURSING: Mailed educational resource kits may be the most efficient and cost-effective way to provide educational support to newly diagnosed patients with breast cancer, but their effect may differ according to region.

Fatigue, weight gain, and altered sexuality in patients with breast cancer: exploration of a symptom cluster.

PURPOSE/OBJECTIVES: To identify the symptom cluster of fatigue, weight gain, and altered sexuality caused by treatment for breast cancer. DATA SOURCES: Published research and literature review articles. DATA SYNTHESIS: Fatigue, weight gain, and altered sexuality commonly occur after breast cancer chemotherapy. Each symptom has a significant impact on quality of life; however, viewing them as a symptom cluster magnifies their impact. CONCLUSIONS: These symptoms have yet to be studied as a cluster. Exercise appears to be an intervention common to each that may be effective in reducing the severity of these treatment side effects. IMPLICATIONS FOR NURSING: Nurses should view symptoms caused by breast cancer treatment holistically, keeping in mind that a reciprocal relationship often exists among symptoms. Identification of symptom clusters with empirically derived interventions may enhance quality of care and quality of life for patients.

Overcoming: breast cancer and its effect on intimacy in middle aged African-American women.

There is a dearth of literature addressing the impact of breast cancer treatments on intimacy in African-American women. Much of what is known about living with the intimate effects of breast cancer comes from studies composed primarily of White women. Grounded theory was used to discover the personal and intimate concerns of middle-aged African-American women diagnosed with breast cancer African-American interviewers conducted interviews with 15 middle-aged African-American women. Constant comparative analysis revealed a core process of "Overcoming" so they could move on with their lives. Overcoming was influenced by their partner standing by them so they could adjust and tell others that they too could survive breast cancer. For these African-American women, ability to overcome was grounded in their spirituality. This study provides suggestions on how to provide culturally appropriate care to middle-aged African-American women with breast cancer in relation to their personal and intimate lives.

The Federal Nursing Services Award. Enlisted women with breast cancer: balancing demands and expectations.

Diagnosis with breast cancer is not an automatic cause for discharge from the military. Therefore, it is important to know how this disease impacts enlisted women in the military. This study describes how enlisted women manage diagnosis and treatment within the context of their military careers. Grounded theory guided the study methodology. Audiotaped semistructured interviews were conducted three times over 9 months to learn how treatment impacted work demands. Data saturation was attained after 46 interviews were conducted. Participants had to balance demands and expectations among the Military Career and Military Medical Subsystems and their Social Support Subsystem. Support from the chain of command was critical in women's ability to balance demands and expectations of career, family, and illness. Military nurses are in a unique position to create strategies that will assist enlisted women in coping with breast cancer.